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David Moyes has revealed Patrick van Aanholt’s late withdrawal from the Spurs game on Sunday came on the advice of an FA medical panel following heart tests.

The 26-year-old was originally named in Sunderland’s starting XI at White Hart Lane but a change was announced just 15 minutes before kick-off, with Jason Denayer taking his place.

The withdrawal clearly came as a surprise to the player, and Moyes would only say afterwards that it had been done on ‘medical grounds’.

But the Black Cats boss has now explained the decision, saying the player had undergone routine cardiology tests after the game against Everton last Monday; and when those results were submitted to the FA medical panel which advises on such matters, they advised Sunderland that he should not play.

That message, though, only reached the manager 35 minutes before kick-off.

Sunderland had the final say over whether to play the Dutchman, and they opted not to take any risks.

Van Aanholt will travel to London with Sunderland for tomorrow’s EFL Cup third round tie against QPR, but no decision has yet been taken over whether he will play in that game.